This page describes the structure and contents of the policy wording.
The permanent disability policy wording is comprised of three documents:
The TotalCareMax Umbrella Wording PDF
The Policy Schedule
The Umbrella Wording is common to all of Sovereign’s TotalCareMax policies. The Benefit Appendix provides details of the permanent disability benefit (also known as total and permanent disablement). The Policy Schedule is customised as it contains personal details such as who is insured and the amount of cover. Each of these parts is summarised as follows:
The Umbrella Wording comprises eight sections, and these cover (in this order) the four major areas of benefits, premiums, claims and policy information. The purpose of each of the eight sections is summarised as follows, with the numbering following that in the Umbrella Wording:
A statement of what your policy is and what benefits it can provide. This section links the Umbrella Document to the Benefit Appendix and the Policy Schedule, and makes those part of the overall policy.
This provides a guarantee that if any applicable section or condition of your policy is enhanced in the future, then that enhancement will automatically be applied to your policy, subject to the conditions specified.
This describes the two inflation adjustment (indexation) options for your policy, namely no indexation at all and indexation which is based on changes in the Consumers Price Index. It also describes how you can increase or reduce the amount of cover under your policy.
This section is a statement of the need to pay the agreed premiums on a regular basis, how premiums can be paid, what happens if you don’t pay a premium on time and when the premium can change. The premium type for your policy is rate for age.
This section describes how to make a claim, and it provides an 0800 claims hotline number for that purpose. It also refers to the Benefit Appendix for information that may be required in order to make a claim.
This section details when and how you can cancel your policy, both during and after the initial 15-day free look period, and what happens if you give notice of cancellation. It also details the circumstances under which Sovereign would be entitled to cancel your policy.
This specifies important information regarding your policy, including what forms part of the policy contract, changes in law, New Zealand jurisdiction, notices to Sovereign and to you, transfer of the ownership of your policy, worldwide cover and how to make a complaint.
This section defines the meanings of special words which are used throughout the document, including ‘Claim Event’, ‘Fraudulently’, ‘Material’, ‘Pass Back Date’, ‘Policy Illustration’, ‘Substantially Incorrect’ and ‘Term Life Insurance Policy’.
The Total and Permanent Disablement Benefit Appendix is comprised of the following sections:
The Policy Schedule comprises the customised part of the policy wording, and it is relatively brief. It specifies the following principal information:
The individual details on the Policy Schedule can be varied by notice or application to Sovereign as applicable, where permitted in accordance with the terms of the Umbrella Wording and Benefit Appendix.
Please note that if you have already taken out a permanent disability insurance policy through KiwiCover, your policy wording may be different from the policy wording referred to above.